Integrated, Real-Time Decision Making
Total Page：16
File Type：pdf, Size：1020Kb
Integrated, Real-Time Decision Making: A Prescription for Improving Patient Outcomes and Your Bottom Line April 2011 Business White Paper White Business COntents INTRODUCTION 3 TODAY’S REALITY 4 THE PATH TO INTEGRATION 5 REAL-WORLD SUCCESSES 7 MEETING SPECIFIC CHALLENGES 9 WHERE TO BEGIN 11 2 WHITE PAPER | Real-TImE Integration INTRODUCTION Almost universally, hospital executives state their mission this way: “Deliver the best possible care for patients while being fiscally responsible.” To achieve this goal they must resolve what is sometimes seen as the tension between optimal patient care and costs. And when in doubt they usually and understandably err on the side of patient care. As a result, many hospitals have succumbed to the “build it and they will come” syndrome. In the laudable desire to ensure that no detail is overlooked they proliferate systems and processes. But because these systems and processes have grown tactically rather than strategically they often remain unintegrated, highly specialized and inflexible. The inability of these disparate systems to consolidate and share data can lead to the very problems of patient care they are intended to prevent – and the ballooning of costs they should help to control. Experience in numerous industries, including healthcare, has shown that integrated business and data systems lead to greater effectiveness and greater efficiency. Such a proven set of Experience in numerous capabilities forms the basis of the majority of financial transactions in the United States. industries, including healthcare, According to a leading market research firm, more than half of leading process-centric has shown that integrated companies and more than one-third of the top 25 process-centric healthcare companies use business and data systems lead such capabilities to provide the end-to-end process visibility required to cost-effectively deliver to greater effectiveness and superior service. greater efficiency. To help you explore the potential of these capabilities for healthcare organizations, this white paper will: • Examine the reality of unintegrated processes and data in healthcare settings • Describe a set of proven tools for achieving integration • Offer real-world examples of healthcare organizations that are applying these tools to affect patient outcomes and control costs • Identify proven approaches to six specific and highly critical challenges for healthcare organizations • Suggest what you can do to begin achieving enterprise integration and real-time decision-making WHITE PAPER | Real-TImE Integration 3 TODAY’S REALITY Hospitals today face a variety of demanding requirements and business imperatives. They need to: • Acquire more patients and avoid losing patients. • Adhere to applicable federal, state and payor requirements without adding extra work to already highly utilized staff. This is a moving target for healthcare institutions. For example, since 2005 the Centers for Medicare and Medicaid Services require reporting on 10 metrics. In 2010 the number increased to 72 metrics. And, most recently, healthcare institutions must address the specifications around “Meaningful Use” tests and reporting to qualify for government funding. • Eliminate adverse events and reduce patient wait times. Today, adverse events are the fourth leading cause of death in the U.S.– mostly around administered drugs. Across the U.S. today, 50 percent of patients don’t get the proper care whether it be preventative, acute or chronic. This might soon be a reportable metric that the industry will be judged on. • Attract best possible staff and increase patient referrals. Unfortunately, numerous obstacles hinder many institutions from fully realizing these goals. These obstacles include siloed systems with little or no integration among them, and complex IT infrastructures that are often hard-wired, proprietary, and outdated. These systems are the result not only of sub-optimal technological approaches but also of political and economic forces. They result in unwieldy processes that alienate patients, contribute to adverse events, and lag behind evolving business requirements. the Burden of Integration There are many nodes of information in healthcare institutions: clinical systems, administrative systems, PACS system, monitoring databases, diagnostic repositories, drug information systems, external systems, and more. However, due to the lack of integration the data in Without the proper information these systems is not contextualized in a way that provides information that can be used by at the proper time, caregivers caregivers. Often, the burden of integration falls on the individual caregiver at the point of must make decisions based on care, or what we call ‘the patient-based moment of truth.’ Without the proper information at experience, not on information. the proper time, caregivers must make decisions based on experience, not on information. These decisions are not just mission-critical, but can also be matters of life and death. Process Complexity Consider a typical business process within a healthcare institution, whether it’s patient admittance from the time they come through the ER to the time they are moved into a room, or any of many other processes. Typically, these processes are quite complex, consisting of many steps that can occur sequentially or sometimes concurrently. A single business process can actually span many departments, service lines, and political boundaries within an institution. These additional layers of complexity can make it difficult to ensure smooth hand-offs and efficient processing, and can hinder the ability to pinpoint the bottlenecks. In fact, when a well-known major consulting firm was hired to map the processes for NASA and highlight problems the project took less than one year. The same consulting firm worked for two years on mapping the processes at a major healthcare provider and gave up. 4 WHITE PAPER | Real-TImE Integration THE PATH TO INTEGRATION You can cut through the complexity and achieve visibility of your processes and business within your institution and across your external partners by moving to a much more flexible IT architecture. Unfortunately, today there are few interconnected systems, and those that are interconnected typically use point-to-point interfaces that require pervasive modifications to accommodate changes to business requirements, making it difficult to comply with evolving mandates. Users must navigate through multiple functional systems to perform a single task. They may have 20 percent of data at their fingertips and then need to get the other 80 percent from other systems. The individual systems don’t communicate easily across func- tional, political, or technical boundaries, which makes it difficult to share information or reuse functionality. service-Oriented Architecture Often the first step in moving from point-to-point data collection to an integrated enterprise is Often the first step in moving to integrate existing data, eventually evolving to the integration of business and clinical from point-to-point data functions. This is the path to Service-Oriented Architecture or SOA. collection to an integrated enterprise is to integrate existing data, eventually SOA provides the flexible information architecture required to decouple business functions evolving to the integration of from hardwired, monolithic legacy applications. Application components or “services” are well business and clinical functions. defined using common interfaces; they utilize a contract to define how services will be invoked, and they interact in a loosely coupled manner. In this environment, the terms “client” and “server” are purely situational. At one moment, an application could act as a client by calling an external service, while moments later, it may act as a service-provider when called by another application to perform a task. When properly implemented, SOA ends the building and maintenance of point-to-point integrations. Using SOA, you can generate new services in a flexible and agile way by combining existing logic and exposing it via reusable services. Once your core business functions have been exposed as services, they can be integrated across organizational boundaries. These loosely coupled services provide you with the ability to respond to changing requirements because of the layer of abstraction that SOA provides between the services and the underlying technology. Meanwhile, SOA governance tools ensure that services and other assets within the SOA continually meet established expecta- tions for security, performance, quality, and reliability. WHITE PAPER | Real-TImE Integration 5 supporting Process Improvement Achieving enterprise integration is just the first step. You still need to address the issue of multiple systems and interfaces to perform a single business function. In other words, you need a way to simplify execution of single tasks and enable integration across functional and technical boundaries. You have no choice but to deal with such business processes. However, you do have a choice of how to improve and manage them. You can implement them through passive technological osmosis that leads to a patchwork of processes that are imperfectly pieced together with point solutions, manual labor, and expensive ERP systems. Or you can employ a reasoned, disci- plined, and innovative approach that confers significant competitive advantages. Using Business Process That’s where Healthcare Process Automation comes into play.